Avalon Court Care Centre

Avalon Court Care Centre is a residential care home providing accommodation and personal care for up to 107 people. It is a purpose-built home in which care is provided across 4 floors. At the time of our inspection visit there were 101 people living at the home. Some of these people were living with dementia, a sensory impairment, physical disabilities and mental health conditions.

People’s experience of using this service and what we found

People were positive about the care they received at Avalon Court Care Centre. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The provider was proactive in ensuring people’s voices were heard and helped shape the future of the home. They had recently invited some people to become ‘Resident Ambassadors’ to speak up on behalf of people.

People were cared for by enough suitably skilled staff who had been recruited safely and received the right training and support to deliver high quality care. Staff were proud to work at Avalon Court Care Centre and valued their role in supporting people to live their best life possible. The registered manager was a visible presence in the home and staff told us they were very open and approachable.

People were safeguarded from abuse and avoidable harm and staff understood their safeguarding responsibilities. The provider assessed risks to ensure people were safe. People had individual risk assessments and care plans that guided staff on how to manage risks associated with their care. People received their medicines as prescribed. Robust systems and processes ensured medicines were ordered, stored, administered, and disposed of safely.

People were supported to eat and drink enough to maintain a balanced diet. Risks around people's diets and nutrition had been identified. Where necessary staff referred people to other healthcare professionals to ensure their nutritional health was maintained. However, we did identify some inconsistency in the quality and accuracy of staff records to manage the risks for people at risk of malnutrition and weight loss. There was no evidence of harm to people and the registered manager took immediate action to improve recording following our inspection.

People were protected from the risk of infection as staff were following safe infection prevention and control practices and the home was exceptionally clean and tidy. Overall, environmental risks were managed safely, and regular checks took place which ensured the building was safe. We identified some potential risks relating to some pieces of equipment. Immediate action was taken to implement more robust checks to ensure any potential risks were further reduced.

Staff regularly monitored people to identify any signs of ill-health. Information was recorded in an electronic monitoring system which supported the early identification of deteriorating health in people. People had regular access to a GP who visited the home weekly.

Systems and process were in place to regularly assess the quality of care provided at the home. The registered manager completed a range of checks using the providers audit tools to improve review and improve standards in the home. Where we identified some improvements were needed in the effectiveness of some checks, the registered manager took immediate action to ensure more robust auditing following our visit.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 30 November 2017).

Why we inspected

This inspection was prompted due to the length of time since the last inspection.

We undertook this focussed inspection to check the quality of service provided. This report only covers our findings in relation to the Key Questions safe, effective and well-led. You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Avalon Court Care Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The home is registered to provide personal and nursing care for up to 101 people. There were 74 people living at the home when we inspected the service. The home changed to the current provider in December 2016 and this was the first inspection under the new provider. Care and support is provided over four floors and the home has a memory unit on the first floor that supports people living with dementia.

A requirement of the service’s registration is that they have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection. We refer to the registered manager as the manager in the body of this report.

Prior to our inspection we had received information of concern relating to the length of time some people had to wait for care staff to attend to them, poor moving and handling techniques and the high level of agency staff used within the home. There were also concerns around the safe administration of medicines. We looked at these concerns as part of our inspection visit.

Staffing numbers were supported by the use of agency care staff. Some people told us they did not always feel confident in the care and support from agency staff who were unfamiliar with their needs. The provider tried to ensure continuity of care by using agency staff that had worked at the home before and robust efforts were being made to recruit new staff. At times some people had to wait for staff to support them with their care at times they preferred.

People were protected against the risk of abuse as the provider took appropriate steps to recruit suitable staff and staff knew how to protect people from harm. Safeguarding concerns were investigated and responded to.

Care plans and risk assessments were in place to protect people and risk assessments were followed to keep people safe. Care plans contained detail about people and how they liked to receive their care. Staff spoken with had a good understanding of people’s care and support needs.

Medicines were stored, administered and disposed of safely. People were supported to access healthcare from a range of professionals inside and outside the home and received support with their nutritional needs. This assisted them to maintain their health and well-being.

The registered manager and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Decisions were made in people’s ‘best interests’ where they could not make decisions for themselves.

Most care staff treated people with kindness, respect and dignity, and supported people to maintain their privacy and independence. People made choices about who visited them at the home. This helped people maintain personal relationships with people that were important to them.

Most people knew how to make a complaint if they needed to and told us they would discuss concerns with staff directly involved in their care. Complaints received were investigated and analysed so that the provider could learn from them. People who used the service, and their relatives, were given the opportunity to share their views about how the home was run.

Quality assurance procedures identified where the service needed to make improvements and where issues had been identified the registered manager took action to continuously improve the service.

People were encouraged to maintain their interests and hobbies and staff supported their personal preferences. People's care records were kept up to date to reflect the care and support they received each day from staff.

Staff were supported by the registered manager, deputy manager and other members of the management team through team meetings and observation. Staff had regular supervision sessions and felt their training and induction supported them to meet the needs of people they cared for.

People and their relatives felt the permanent staff had the skills and knowledge to support people well, however there were some concerns from people regarding the level of knowledge of some agency staff employed in the home.

The registered manager and deputy manager felt well supported by the provider who visited regularly. The provider carried out audits of the service to monitor the quality and effectiveness of the service provided.